Weird. It has no effect on survival in rats and the doses were large.<p>> One chronic (78-weeks) study in rats with dietary levels of 0, 1, 3, or 10% erythritol (equal to
> 0.46, 1.4 and 5 g/kg bw/day for males and 0, 0.54, 1.7 and 5.7 g/kg bw/day for females) (Til
> and van Nesserooij, 1994) and another 2-year chronic toxicity/carcinogenicity study in rats
> with dietary levels of erythritol of 0, 2, 5, or 10% (equal to 0, 0.9, 22, and 4.6 g/kg bw/day for
> males and 0, 1.0, 2.6, and 5.4 g/kg bw/day) (Lina et al., 1994; 1996) demonstrated that
> erythritol did not affect survival and had no carcinogenic effect.<p><a href="https://ec.europa.eu/food/fs/sc/scf/out175_en.pdf" rel="nofollow">https://ec.europa.eu/food/fs/sc/scf/out175_en.pdf</a><p>From this paper:<p>> In a population-based prospective cohort study with repeated dietary records, ingestion of multiple artificial sweeteners (for example, aspartame, acesulfame potassium and sucralose) was associated with CVD risk.<p>Ok, let's look at that reference.<p>> Results Total artificial sweetener intake was associated with increased risk of cardiovascular diseases (1502 events, hazard ratio 1.09, 95% confidence interval 1.01 to 1.18, P=0.03); absolute incidence rate in higher consumers (above the sex specific median) and non-consumers was 346 and 314 per 100 000 person years, respectively. Artificial sweeteners were more particularly associated with cerebrovascular disease risk (777 events, 1.18, 1.06 to 1.31, P=0.002; incidence rates 195 and 150 per 100 000 person years in higher and non-consumers, respectively). Aspartame intake was associated with increased risk of cerebrovascular events (1.17, 1.03 to 1.33, P=0.02; incidence rates 186 and 151 per 100 000 person years in higher and non-consumers, respectively), and acesulfame potassium and sucralose were associated with increased coronary heart disease risk (730 events; acesulfame potassium: 1.40, 1.06 to 1.84, P=0.02; incidence rates 167 and 164; sucralose: 1.31, 1.00 to 1.71, P=0.05; incidence rates 271 and 161).<p>This study shows the same thing with _all_ artificial sweeteners, and has way more people (n=103,388) than the present Nature study (n=1,157). And we know that erythritol is often used by type 2 diabetics due to its low effect on insulin levels. That population is predisposed to cardiac events to begin with.<p>When adjusting the US/EU cohorts for cardiovascular risk factors, the observed effect with erythritol are smaller and closer to this study of other artificial sweeteners.<p>> Consistent with the results observed within the discovery cohort (adjusted HR = 2.95 (1.70–5.12) P < 0.001; Fig. 1 and Supplementary Table 4), the association between erythritol levels (fourth quartile versus first quartile) and incident MACE risk remained significant in both US and European validation cohorts following adjustments for cardiovascular risk factors (adjusted HR (95% CI) = 1.80 (1.18–2.77) and 2.21 (1.20–4.07), P = 0.007 and P = 0.010, respectively<p>I'm not convinced of the validity of this study. They ignored the rat chronic toxicity data and proposed a mechanism for what they saw in a small cohort of humans, but it should be reproducible in mammals.